MEDICARE: TERESA GONZALEZ-KURZY LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH12916	FL

General Provider Information

NPI Number	:	1184890360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA GONZALEZ-KURZY LMHC

Provider Business Mailing Address
First Line	:	1317 EDGEWATER DR # 580
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6350
Country	:	US
Telephone Number	:	941-564-7987
Fax Number	:	941-761-5815

Provider Business Practice Location Address
First Line	:	1317 EDGEWATER DR # 580
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6350
Country	:	US
Telephone Number	:	941-564-7987
Fax Number	:	941-761-5815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	10/24/2020

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